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N126-U3-I. MI/CHF#10
Dobrisky-CHF and pulmonary edema
| Question | Answer |
|---|---|
| Heart failure is defined as | when the heart is unable to pump sufficient blood carrying oxygen and nutrients to adequately perfuse tissues |
| Heart failure can be the result of what conditions | CAD, MI, HTN, COPD, hyperthyroidism, substance abuse, heart valve disease |
| HTN can result in CHF due to what condition | cardiomegaly |
| Hyperthyroidism and other metabolic alterations can lead to CHF as a result of an increase in what | CO |
| Substance abuse can lead to CHF by causing what | cardiomyopathy and/or MI |
| Acute Heart Failure is the most common reason for hospital admission in what age group | elderly |
| Acute heart failure occurs rapidly with the onset of | severe signs and symptoms of failure |
| Acute heart failure requires immediate treatment or it will lead to | cardiogenic shock |
| Chronic failure can be treated with what | oral drugs, diet, exercise |
| MI will lead to what sided CHF | left sided |
| Left sided heart failure presents with what types of S/S | respiratory |
| Right sided heart failure presents with what types of S/S | volume overload |
| Fatigue, dyspnea, orthopnea, chest pain, anxiety and paroxysmal nocturanl dyspnea are all s/s of which type of failure | left sided |
| Tachycardia is considered a compensatory mechanism for which type of heart failre | left sided |
| Heart failure is classified from 1-4, 4 being | final stage |
| What type of sputum can be expected from a pt with Left sided heart failure | pink or white, frothy sputum |
| Describe cheyne-stokes respiration | slow to rapid then slow again and then stops momentarily |
| Patients with left sided heart failure can be expected to where oxygen when | > at night and sometimes during the day |
| Define orthopnea | SOB when lying flat |
| Depended edema is associated with which type of heart failure | right sided |
| Define cachexia | muscle wasting in arms and legs |
| a pt with left sided heart failure may experience what type of changes in their BP | hypertension followed by hypotension and shock |
| distended jugular veins are associated with what type of heart failure | right sided |
| Which sided heart failure is considered to be a volume problem | right sided |
| peripheral edema, ascites and JVD are all s/s of which type of heart failure | right sided |
| Decreased bowel signs are associated with which side | right sided |
| A BNP result of >100 is a classic sign of what condition | CHF |
| What type of tests are done to determine the size of the heart and valve and chamber size | CXR & cardiac echo |
| Nuclear ventriculography is used to visualize what | perfusion through the heart |
| Angiography is also called | cardiac catheterization |
| Cardiac enzymes, serum chemistry, liver enzymes, thyroid and CBC are all ordered to rule out what | MI |
| What activity level is best to promote diuresis for these patients | bedrest |
| if a patient has pulmonary edema what angle should the HOB be placed in | 90 degrees |
| Cardioversion for A Fib may include what two methods | defibrillation and/or meds |
| What dietary changes are expected to be ordered in a CHF pt | fluid restrictions, low Na |
| a low sodium diet will help decrease the workload on the heart by promoting what | diuresis |
| A CHF patient should be encouraged to eat what types of meals | frequent, small meals with adequate protein |
| Diuretics, ACE inhibitors, beta blockers, digoxin and aldosterone antagonists are all used in the treatment of | heart failure |
| What med will be administered to reduce fluid overload or preload | diuretics |
| When administering diuretics, patients in diastolic failure, should be watched cautiously for what possible complication | extreme hypotension |
| diastolic failure is a filling problem | |
| systolic failure is a output problem | |
| diastolic filling | |
| systolic output | |
| Losartin (Cozaar) preserves myocardium by preventing what | scar tissue |
| Furosemide (Lasix) when given IV push, should be given at what rate per min | 1ml/min |
| What vital sign should be monitored while administering Lasix | BP |
| what two types of diuretics may be compbined for greater diuresis | loop & thiazide |
| ***Enalapril (Vasotec) is in what class of diuretics | ACE inhibitors |
| What class of drug is essential for treating heart failure | ACE inhibitors |
| Enalapril (Vasotec) elevates what in the blood | K+ |
| what effect does Enalapril have on preoad & afterload and how | reduces both by vasodilating |
| what three complications should be monitored for with Enalapril | hyperkalemia, hypotension, fluid depletion |
| Losartin (Cozaar) is in what class of drug | diuretic, angiotensin receptor blocker |
| beta blockers relieve CHF by | slowing heart rate and allowing for complete filling |
| Carvedilol (Coreg) and Metoprolol (Lopressor) are in what class of drug | antidiuretic, beta blockers |
| Beta blockers should be held if the systolic bp & hr are | sbp <90 and hr <60 |
| Coreg or Lopressor are almost always given before what cardiac procedure | cardiac catheterization |
| Calcium channel blockers should not be given to patients with what type of ventricular dysfunction | severe left ventricular dysfunction |
| Norvasc is a | calcium channel blocker |
| Digitalis is usually given if the pt has had no response to other drugs or | they are in Afib |
| Hypokalemia has what effect on dig toxicity | enhances dig toxicity |
| The first sign of dig toxicity is considered to be | anorexia |
| yellow green halos around lights and confusion are both s/s of | dig toxicity |
| What effect does dig have on the HR | slows the heart rate |
| Negative chronotropic effect of dig is | slows the heart rate |
| Negative dromotropic effect of dig is | slows conduction velocity |
| beta blockers and calcium channel blockers when used with dig may enhance what effect of dig | bradycardia |
| When administering aldosterone antagonists monitor for | hyperkalemia |
| Nitrates and morphine decrease preload by | dilating veins, causing venous pooling |
| To relieve dynea, elevate HOB | 45 |
| To relieve pulmonary edema elevate HOB | 90 |
| differentiate between inotropic, chronotropic and dromotropic | inotropic-contraction; chronotropic-rate; dromotropic-electrical |
Created by:
Lori Dobrisky
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